Journalist and former Seattle Post-Intelligencer editor Mark Trahant kicked off the fourth annual National Urban Indian Health Conference at Seattle University last week by lauding the progress of Indian Health Services, the federal government's health program for American Indians, which he sees as a potential model for national health care reform.
Attendees of the conference praised the efforts of IHS -- but quickly brought the conversation to the urban Indian population, the 60 percent of American Indians living in metropolitan areas.
Only 36 percent of those receiving help from Indian Health Services reside outside of tribal reservations. Typically, they have less access to hospitals; instead, they go to health clinics supported by the IHS and tribal health programs.
The complex issues raised throughout the conference reflect the variety of challenges that urban Indians face. Representatives from 34 urban health institutions across the country discussed practical ways to address the most prevalent health concerns seen among the hundreds of thousands of American Indians living off of reservations -- including rising domestic violence, unemployment, and chemical dependency.
This is the only annual conference of its kind taking place in the U.S. and has had great success to date, sparking enthusiasm for innovative new programs and providing -- the impetus for more research on a little understood group of people.
Ralph Niquera, executive director of the Seattle Indian Health Board, which hosted the conference, notes, "We established [this gathering] four years ago to really get other urban Indian health institutions around the country together in a more intimate kind of place. We design the program so that the topics are topics our colleagues have told us are of interest to them."
Dialogues that drew particular interest this year were those related to the national economic downturn, according to Debbie Baruso, the Conference Administrative Services Coordinator.
"We saw a rise [this year] in domestic and substance abuse because of the economy, and realized we needed to bring together health care providers to address those needs," she says. "The ideal outcome [for this conference] is at least to be aware of how specifically the native population is being impacted by the current economy, for example by increasing the number of assessments done at the chemical dependency centers.... We're looking not to generate answers so much as to network and come together to talk about best practices."
Many of the clinics used the impetus of providing a healthy environment for the youngest generation of urban American Indians to inspire change within the community. One of the most affecting presentations of the conference featured a series of television Public Service Announcements produced by teenagers from the Duwamish and other local tribes, testifying to their personal experience with tobacco addiction, a common health concern among American Indians. The PSAs stressed that tobacco has a place in ritual for many tribes, but should not be abused.
Niquera says the conference generates a strong sense of community. "Urban programs around the country are doing remarkable work, considering the fact that they are so underfunded," he says.
"We're so hidden that sometimes providers feel [they're] all alone out there.... We want to expose these places and show that there are others like them."
Clinics' cooperation, says Niquera, is making an impact on public policy. The national Urban Indian Health Institute tackles undertakes research projects to benefit urban American Indian/Alaska Natives, and often can provide clinics with data unavailable from the national census. UIHI's latest initiative aims to increase breast and cervical cancer screenings.
The Obama administration, apparently in recognition of these health institutes' importance, has already asked Congress for an increase of 13 percent, funding the Indian Health Services at $4.03 billion for fiscal year 2010.